This article by Dr. Jesse Stoff appeared on Southampton Patch on April 23, 2011
A. J. in Sagaponack asks: I seem to be always sick with something and not healing well. Any thoughts?
When my daughter, Summer, gets a small cut on her finger and asks for a Band-Aid, she does so with the full expectation that when the Band-Aid is removed a couple of days later, the cut will have been “magically” healed. She is usually rewarded by her faith in her body’s healing capacity.
On a macroscopic level, healing appears to us as a miracle or as magic because of all the little elements that go into the repair of the damaged tissue. The removal of foreign material and destruction of harmful bacteria all happens in a microscopic world that is not directly accessible to our unaided eye.
My daughter’s unquestioning child’s faith in the healing powers and magic of her body are also an important ingredient when it comes to healing more severe or recurrent diseases. Left to its own devices, the body tends towards health. When someone doesn’t heal well or keeps getting sick there is reason that lies in one or more of the five areas that affect the integrity of our immune system. The first of these is nutrition. Nutrition supplies the basic biochemical building blocks that provide the infrastructure for our immune system to function properly. Just eating a broad diet doesn’t guarantee that you’ll get what your immune system needs because there are issues of the quality of the food and the efficiency of the digestive system to be reckoned with.
Infection is the second area that affects the functioning of our immune system. Viruses that directly attack immune function like EBV, CMV and HIV will have long term consequences on our ability to protect ourselves from future infections. EBV and CMV are common. More than 96 percent of the population have been exposed to them at some point. Imbalances in the micro-organisms in our digestive tract will also have a profound affect on immune system.
As a consequence of our industrialization, toxins now abound throughout our environment. A casual perusal of http://toxnet.nlm.nih.gov will give you some small idea of how big and prevalent the problem is. That’s why it is important to limit your exposure to toxins wherever you can such as choosing to eat as much organic food as you can and drinking plenty of pure water, fluoride not included.
Trauma is the next agent of immunological suppression. The only form of trauma that can directly hurt our immune system is that which comes from the exposure to radiation. This not only brings to mind Chernobyl, Three Mile Island and Fukushima but also commercial flight. When you are cruising at 35,000 feet, you are above much of the atmosphere that protects us from ionizing radiation. Studies have shown that air flight personnel have a higher incidence of severe and chronic diseases because of this.
The fifth horseman of immunological apocalypse is stress. The term stress was coined by Dr. Hans Selye just more than 70 years ago. According to Selye, “dis-ease is an attack on any particular aspect of your body or mind that creates a distressed physiology.” Stress is an individual’s non-specific response to any stimulus, conscious or unconscious, physical or physiological. It is such an integral component of our existence that Selye has stated that, “Complete freedom from stress is death.” There are two categories of stress: eustress (characterized by happiness and enjoyment) and distress (characterized by anguish, tension and worry). During distress the adrenal glands secrete the steroid hormone cortisol to excess and without the normal cycling that usually occurs, which will then suppress immune function.
Based on your history and physical findings, lab tests can determine the best way to proceed both by answering the question of why your immune system isn’t protecting you as it should and what medical disorders you have now that should be directly addressed.
Saturday, April 23, 2011
Saturday, April 16, 2011
What To Do About Stubborn Acne
This article by Dr. Jesse Stoff appeared on Southampton Patch.
This question comes from P.L. in Hampton Bays: I have recently been getting more acne and it is very stubborn and resistant to the treatments that I’ve tried. Any ideas?
Most people know that those familiar yet annoying red and white pimples of acne are largely influenced by hormones.
Hormone levels and their balance influence the production of sebum, the oily skin lubricant. Fluctuating hormone levels cause the sebum to get thicker and clog skin pores, trapping otherwise harmless bacteria and allowing a small local infection to occur known as acne. Treatment can be a bit tricky. The use of long term antibiotics can throw the delicate balance of intestinal micro-organisms out of whack leading to chronic digestive problems and bigger health problems. Topical lotions and creams can dry out the skin causing cracking and allowing the bacteria to track in deeper and can just be uncomfortable to deal with.
Your action plan should include addressing the known nutritional deficiencies that can predispose to acne infections by lowering your immunological resistance. Amino chelated zinc — that is zinc that is attached to an amino acid like zinc gluconate or methionine — vitamin C, vitamin A, probiotics, like acidophilus, and essential fatty acids are helpful in supporting immune function. Eating a diet that is higher in predominantly organic vegetables than animal proteins is helpful in reducing some hormonal stress. Lower fat diets seem to make it easier to get acne under control. Getting more and higher quality sleep — which means going to sleep by 10, not to watch TV — is also important as it will reduce stress levels that can further throw your hormones out of balance. Increasing your water intake, regular exercise and addressing possible underlying food allergies, like we do in the office, are all very helpful in stopping and reversing acne.
Skin inflammation is a common symptom of allergies and if you have recurrent acne it may be worth looking into. Topically a non-petroleum based cream, like lanolin, with tea tree oil and Calendula can be very helpful. Warm Epsom salt water compresses, or yellow clay are better for drawing out the infected material than jabbing a needle into it and possibly spreading the bacteria deeper.
This question comes from P.L. in Hampton Bays: I have recently been getting more acne and it is very stubborn and resistant to the treatments that I’ve tried. Any ideas?
Most people know that those familiar yet annoying red and white pimples of acne are largely influenced by hormones.
Hormone levels and their balance influence the production of sebum, the oily skin lubricant. Fluctuating hormone levels cause the sebum to get thicker and clog skin pores, trapping otherwise harmless bacteria and allowing a small local infection to occur known as acne. Treatment can be a bit tricky. The use of long term antibiotics can throw the delicate balance of intestinal micro-organisms out of whack leading to chronic digestive problems and bigger health problems. Topical lotions and creams can dry out the skin causing cracking and allowing the bacteria to track in deeper and can just be uncomfortable to deal with.
Your action plan should include addressing the known nutritional deficiencies that can predispose to acne infections by lowering your immunological resistance. Amino chelated zinc — that is zinc that is attached to an amino acid like zinc gluconate or methionine — vitamin C, vitamin A, probiotics, like acidophilus, and essential fatty acids are helpful in supporting immune function. Eating a diet that is higher in predominantly organic vegetables than animal proteins is helpful in reducing some hormonal stress. Lower fat diets seem to make it easier to get acne under control. Getting more and higher quality sleep — which means going to sleep by 10, not to watch TV — is also important as it will reduce stress levels that can further throw your hormones out of balance. Increasing your water intake, regular exercise and addressing possible underlying food allergies, like we do in the office, are all very helpful in stopping and reversing acne.
Skin inflammation is a common symptom of allergies and if you have recurrent acne it may be worth looking into. Topically a non-petroleum based cream, like lanolin, with tea tree oil and Calendula can be very helpful. Warm Epsom salt water compresses, or yellow clay are better for drawing out the infected material than jabbing a needle into it and possibly spreading the bacteria deeper.
Saturday, April 9, 2011
Why Am I Tired All The Time Since My Pregnancy?
This article by Dr. Jesse Stoff appeared on Southampton Patch.
This week's question comes from M.M. in Tuckahoe: Since I recently gave birth to my son, I have been so very fatigued, but all of my blood tests look “good.” Any thoughts?
As with any health problem, in order to feel better you first have to know what’s wrong.
Looking for a quick fix rarely gives lasting results. In fact, taking stimulants will, in the long run, usually make the problem worse, so put the coffee down and let’s sort this out.
As with any problem, we start at the beginning with a differential diagnosis. Unfortunately, in the various textbooks of differential diagnosis, the list of illnesses that have fatigue as a major component of their presentation goes on for pages and pages of very small print. If the fatigue is really debilitating then that list has to be seriously looked at.
This is where experience and common sense come in handy as a way to eliminate most of the causes. For instance, since you recently gave birth to your son (congratulations, by the way) then it’s a safe bet that you don’t have prostate cancer. But, there is a variety of problems with your endocrine system (balance of hormones) that can cause severe fatigue and are related to pregnancy. Some of these include thyroid or adrenal imbalances and diabetes, just to get us started. The “usual” blood tests won’t pick up an early thyroiditis, for example, as special blood tests are needed and must be specifically ordered.
During pregnancy there are many changes that occur to your biochemistry. With the increased demands placed upon it, nutritional deficiencies are a real possibility. Since biochemistry underlies everything, if it gets out of balance your hormones can quickly follow suit and a so called post-partum depression may ensue, which often has fatigue as a prominent symptom.
Furthermore, many changes occur to your immune system during those blessed 40 weeks which can result in the onset of new allergies, re-activation of a dormant viral infection or the development of an autoimmune problem where, again, severe fatigue is a leading problem.
It’s not good medical practice to just do an Epstein-Barr VCA IgG antibody test, have it come back positive and say that you have “chronic fatigue syndrome” (CFS). To diagnose a chronic or reactivated EBV infection requires a six-antibody blood test panel; anything less is guess work. Also, according to the CDC, before you can diagnose CFS you must eliminate that looooong list of differential diagnoses, that I mentioned, and then methodically address the problems that show up. Taking short cuts won’t work.
In the mean time, attend to what you can: a good, balanced, predominantly organic food diet; going to sleep — not to bed to read or watch TV — by 10 p.m. is very important; mild, regular exercise, plenty of water and enlisting help from hubby are all very helpful steps that you can take today and are not to be underestimated. Beyond that, a thorough medical evaluation followed by well coordinated integrative care is your best bet for regaining your health.
This week's question comes from M.M. in Tuckahoe: Since I recently gave birth to my son, I have been so very fatigued, but all of my blood tests look “good.” Any thoughts?
Looking for a quick fix rarely gives lasting results. In fact, taking stimulants will, in the long run, usually make the problem worse, so put the coffee down and let’s sort this out.
As with any problem, we start at the beginning with a differential diagnosis. Unfortunately, in the various textbooks of differential diagnosis, the list of illnesses that have fatigue as a major component of their presentation goes on for pages and pages of very small print. If the fatigue is really debilitating then that list has to be seriously looked at.
This is where experience and common sense come in handy as a way to eliminate most of the causes. For instance, since you recently gave birth to your son (congratulations, by the way) then it’s a safe bet that you don’t have prostate cancer. But, there is a variety of problems with your endocrine system (balance of hormones) that can cause severe fatigue and are related to pregnancy. Some of these include thyroid or adrenal imbalances and diabetes, just to get us started. The “usual” blood tests won’t pick up an early thyroiditis, for example, as special blood tests are needed and must be specifically ordered.
During pregnancy there are many changes that occur to your biochemistry. With the increased demands placed upon it, nutritional deficiencies are a real possibility. Since biochemistry underlies everything, if it gets out of balance your hormones can quickly follow suit and a so called post-partum depression may ensue, which often has fatigue as a prominent symptom.
Furthermore, many changes occur to your immune system during those blessed 40 weeks which can result in the onset of new allergies, re-activation of a dormant viral infection or the development of an autoimmune problem where, again, severe fatigue is a leading problem.
It’s not good medical practice to just do an Epstein-Barr VCA IgG antibody test, have it come back positive and say that you have “chronic fatigue syndrome” (CFS). To diagnose a chronic or reactivated EBV infection requires a six-antibody blood test panel; anything less is guess work. Also, according to the CDC, before you can diagnose CFS you must eliminate that looooong list of differential diagnoses, that I mentioned, and then methodically address the problems that show up. Taking short cuts won’t work.
In the mean time, attend to what you can: a good, balanced, predominantly organic food diet; going to sleep — not to bed to read or watch TV — by 10 p.m. is very important; mild, regular exercise, plenty of water and enlisting help from hubby are all very helpful steps that you can take today and are not to be underestimated. Beyond that, a thorough medical evaluation followed by well coordinated integrative care is your best bet for regaining your health.
Saturday, April 2, 2011
Lyme Disease Symptoms May Continue After Treatment
This article by Dr. Jesse Stoff appeared on Southampton Patch.
Today’s question is from E.K. in Water Mill: Last summer I was bitten by a tick. Afterwards I had a red ringed rash around the bite site and felt sick. My doctor said that it was probably early Lyme disease and that I should take antibiotics, which I did. The rash went away but I still feel tired and achy and my blood tests are negative for Lyme disease. Any thoughts?
Lyme disease is caused by a spirochete called Borrelia burgdorferi, and is the most common tick-borne disease in the United States. The number of reported cases has more than doubled between 1992 and 2006, and almost 29,000 new confirmed cases were reported in 2008. Additional studies have shown that the actual number of cases of Lyme disease may exceed reported cases by a factor of 6 to 12 in endemic areas, such as where we live. There are several other infectious organisms that can be transmitted with the Borrelia spirochete and these co-infections can be as bad or worse as Lyme disease itself. The principle means of transmission of the disease is a tiny tick and at this point all of the different types of ticks are known to carry these infections. If you remove a tick from your skin you should save it and have it tested, through your local clinical laboratory, for Lyme disease.
Although common, in certain areas, some aspects of Lyme disease continue to be poorly understood and are a source of intense controversy among patients, physicians and researchers. When correctly diagnosed, the majority of patients, with acute Lyme disease, can be usually treated with a standard course of antibiotics such as Doxycycline. However, 10 percent to 20 percent of patients with acute Lyme disease, after completing the standard course of antibiotic therapy, still have symptoms. Some of these patients have an untreated co-infection, others still have an active Borrelia infection and a third group go on to develop chronic symptoms now identified as post-Lyme disease syndrome.
Post-Lyme syndrome seems to be a secondary auto-immune response to a cross reactive antigen to the Borrelia organism. These patients usually have abnormalities in their blood tests that range from an increase in inflammatory markers to evidence of anti-neuronal antibodies. These antibodies can attack the central nervous system and can account for a wide range of variable and changing symptoms. Treatment options also vary and may include; the use of anti-inflammatory supplements and/or drugs, antigen desensitization to raise the number and activity of TR1 suppressor cells all the way to the use of immuno-suppressive drugs in severe cases. Individual treatment varies depending upon the specific blood test results.
Lyme disease is caused by a spirochete called Borrelia burgdorferi, and is the most common tick-borne disease in the United States. The number of reported cases has more than doubled between 1992 and 2006, and almost 29,000 new confirmed cases were reported in 2008. Additional studies have shown that the actual number of cases of Lyme disease may exceed reported cases by a factor of 6 to 12 in endemic areas, such as where we live. There are several other infectious organisms that can be transmitted with the Borrelia spirochete and these co-infections can be as bad or worse as Lyme disease itself. The principle means of transmission of the disease is a tiny tick and at this point all of the different types of ticks are known to carry these infections. If you remove a tick from your skin you should save it and have it tested, through your local clinical laboratory, for Lyme disease.
Although common, in certain areas, some aspects of Lyme disease continue to be poorly understood and are a source of intense controversy among patients, physicians and researchers. When correctly diagnosed, the majority of patients, with acute Lyme disease, can be usually treated with a standard course of antibiotics such as Doxycycline. However, 10 percent to 20 percent of patients with acute Lyme disease, after completing the standard course of antibiotic therapy, still have symptoms. Some of these patients have an untreated co-infection, others still have an active Borrelia infection and a third group go on to develop chronic symptoms now identified as post-Lyme disease syndrome.
Post-Lyme syndrome seems to be a secondary auto-immune response to a cross reactive antigen to the Borrelia organism. These patients usually have abnormalities in their blood tests that range from an increase in inflammatory markers to evidence of anti-neuronal antibodies. These antibodies can attack the central nervous system and can account for a wide range of variable and changing symptoms. Treatment options also vary and may include; the use of anti-inflammatory supplements and/or drugs, antigen desensitization to raise the number and activity of TR1 suppressor cells all the way to the use of immuno-suppressive drugs in severe cases. Individual treatment varies depending upon the specific blood test results.
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